POS0563 USE OF A DIGITAL SOLUTION TO MONITOR CHRONIC INFLAMMATORY RHEUMATIC MUSCULOSKELETAL DISEASES: FINAL RESULTS OF THE DIGIREUMA STUDY
Authors: D. Benavent, L. Fernández-Luque, M. Sanz, V. Navarro-Compán, M. Novella-Navarro, I. Bilionis, E. Calvo-Aranda, L. Lojo, A. Balsa, C. Plasencia
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with rheumatic and musculoskeletal diseases (RMDs) require a tailored follow-up, which may be limited by the healthcare resources. Innovative tools that save time need to be implemented effectively in the clinical care of patients with RMDs. <h3>Objectives</h3> To test the feasibility of a digital solution for real-time monitoring of electronic patient reported outcomes (ePROs) in patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA). <h3>Methods</h3> Digireuma was a bicentric 6-month prospective study including patients with RA and SpA, using a digital solution, namely Adhera Rheumatology Digital Program. During follow-up, patients had a hybrid follow-up: face-to-face -baseline and 6 months visits-and digital. In the digital follow-up, patients were asked to report disease specific ePROs on a pre-established basis in the mobile solution- including at least one assessment per week. In addition, flares and incidences with medication were available to be reported at any time. Four rheumatologists monitored these outcomes, and contacted patients when deemed necessary (<b>Figure 1</b>). Assessment measures included patient global assessment (PGA) of disease activity, (self-reported) tender joint count (TJC) and swollen joint count (SJC), Health Assessment Questionnaire (HAQ) and pain visual analogue scale (VAS), for patients with RA; PGA, TJC, SJC, BASDAI, and ASAS-Health Index, for patients with SpA. All measures were delivered every two weeks. Engagement at 3 and 6 months was assessed. <h3>Results</h3> Out of 56 recruited patients, 51 (24/27 (89%) RA, 27/29 (93%) SpA) downloaded and used the mobile solution and 47 (84%) submitted at least one ePROs entry. Median age (IQR) was 47 (13.2) and 40 (16.0) years in the RA and SpA groups, respectively. 20/27 (74%) patients with RA and 14/29 (48%) with SpA were female. In the RA group there were a total of 2156 digital solution accesses (57 per patient) in 6 months, while patients with SpA had a total of 1644 accesses (29 per patient). ePROs measurements outcomes at baseline and 6 months are shown in <b>Table 1</b>. Patients with RA completed a median of 6710 ePROs interactions during follow-up, whereas patients with SpA completed a median of 4315. Regarding alerts, among a total of 52 notifications, 47 were deemed necessary to be contacted (5 cases were assessed directly in a programmed consultation, due to time-proximity). Among all alerts, 45 were flares (31 RA, 14 SpA) and 4 problems with the medication (3 causes were not registered). Of the 47 cases that were contacted, 36 (77%) were managed remotely, 9 (19%) required a face-to-face intervention and in 2 (4%) cases it was not possible to reach patients before consultation. Regarding engagement, at three months 26 patients (55%)- 15 with RA and 11 with SpA- continued submitting data periodically, while at six months 22 patients (47%)- 13 with RA and 9 with SpA- continued submitting any data. <h3>Conclusion</h3> This study shows that ePROs can be used to monitor disease activity, flares, and medication issues in patients with RA and SpA, with three out of four alerts being managed remotely. After six months, more than half of the patients showed non-adherence to the monitoring plan/digital solution. The participation of both healthcare professionals and patients is critical for the successful implementation of mobile health in clinical practice, specially to identify long term usage strategies. <h3>Acknowledgements</h3> This study was funded by an unrestricted grant from Abbvie. <h3>Disclosure of Interests</h3> Diego Benavent Speakers bureau: Janssen, Roche, Galapagos., Grant/research support from: Novartis, Abbvie., Luis Fernández-Luque Employee of: Employee of AdheraHealth Inc., María Sanz: None declared, Victoria Navarro-Compán Speakers bureau: AbbVie, Eli Lilly, Janssen, MSD, Novartis, Pfizer, UCB Pharma, Consultant of: AbbVie, Eli Lilly, MSD, Novartis, Pfizer, UCB Pharma, Grant/research support from: AbbVie and Novartis, Marta Novella-Navarro Speakers bureau: Galapagos, UCB, Lilly and Janssen, Grant/research support from: UCB, Lilly and Janssen, Ioannis Bilionis Employee of: Employee of AdheraHealth Inc, Enrique Calvo-Aranda Speakers bureau: Abbvie, LETICIA LOJO: None declared, Alejandro Balsa Speakers bureau: Pfizer, Abbvie, Lilly, Galapagos, BMS, Sandoz, Nordic Pharma, Gebro, Roche, Sanofi, UCB, Consultant of: Pfizer, Abbvie, Lilly, Galapagos, BMS, Nordic Pharma, Sanofi, UCB, Grant/research support from: Pfizer, Abbvie, BMS, Nordic Pharma, Gebro, Roche, UCB, Chamaida Plasencia Speakers bureau: Pfizer, Abbvie, Lilly, Sandoz, Sanofi, Biogen, Roche, Novartis, Grant/research support from: Pfizer and Abbvie.